Volumetric Growth and Growth Curve Analysis of Residual Intracranial Meningioma.



Gillespie, Conor S ORCID: 0000-0002-9153-3077, Richardson, George E, Mustafa, Mohammad A ORCID: 0000-0002-7703-0174, Taweel, Basel A ORCID: 0000-0002-6157-2438, Bakhsh, Ali ORCID: 0000-0002-5796-4316, Kumar, Siddhant ORCID: 0000-0001-8084-2504, Keshwara, Sumirat M ORCID: 0000-0001-5390-9996, Islim, Abdurrahman I, Mehta, Shaveta ORCID: 0000-0003-4990-3975, Millward, Christopher P ORCID: 0000-0001-7727-1157
et al (show 3 more authors) (2022) Volumetric Growth and Growth Curve Analysis of Residual Intracranial Meningioma. Neurosurgery, 92 (4). pp. 734-744.

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Abstract

<h4>Background</h4>After meningioma surgery, approximately 1 in 3 patients will have residual tumor that requires ongoing imaging surveillance. The precise volumetric growth rates of these tumors are unknown.<h4>Objective</h4>To identify the volumetric growth rates of residual meningioma, growth trajectory, and factors associated with progression.<h4>Methods</h4>Patients with residual meningioma identified at a tertiary neurosurgery center between 2004 and 2020 were retrospectively reviewed. Tumor volume was measured using manual segmentation, after surgery and at every follow-up MRI scan. Growth rates were ascertained using a linear mixed-effects model and nonlinear regression analysis of growth trajectories. Progression was defined according to the Response Assessment in Neuro-Oncology (RANO) criteria (40% volume increase).<h4>Results</h4>There were 236 patients with residual meningioma. One hundred and thirty-two patients (56.0%) progressed according to the RANO criteria, with 86 patients being conservatively managed (65.2%) after progression. Thirteen patients (5.5%) developed clinical progression. Over a median follow-up of 5.3 years (interquartile range, 3.5-8.6 years), the absolute growth rate was 0.11 cm 3 per year and the relative growth rate 4.3% per year. Factors associated with residual meningioma progression in multivariable Cox regression analysis were skull base location (hazard ratio [HR] 1.60, 95% CI 1.02-2.50) and increasing Ki-67 index (HR 3.43, 95% CI 1.19-9.90). Most meningioma exhibited exponential and logistic growth patterns (median R 2 value 0.84, 95% CI 0.60-0.90).<h4>Conclusion</h4>Absolute and relative growth rates of residual meningioma are low, but most meet the RANO criteria for progression. Location and Ki-67 index can be used to stratify adjuvant treatment and surveillance paradigms.

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 17 Jan 2023 11:26
Last Modified: 17 Mar 2023 03:45
DOI: 10.1227/neu.0000000000002268
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3167094